CAJ | 학술논문

【目的】观察远隔缺血同处理（RIPerC）与远隔缺血预处理（RIPreC）在瓣膜置换手术中对乳酸（LA）和白介素6（IL‐6）及氧合指数（PaO2／FiO2）的影响。【方法】选取瓣膜置换术的患者120名，将其随机分为三组：对照组（A组），下肢缺血同处理组（B组）和下肢缺血预处理组（C组），每组40名。B组于体外循环主动脉阻断后实行3个周期缺血／再灌（5／5 min）的右下肢缺血时处理，C组于气管插管麻醉后进行3个周期5／5 min的右下肢缺血预处理。观测术后三组患者的呼吸机撤离时间，ICU停留时间，IL‐6，PaO2／FiO2，LA的变化。【结果】和对照组比较，B组和C组呼吸机撤离时间和ICU停留时间明显缩短，PaO2／FiO2较对照组高，IL‐6和LA较对照组低，但两个处理组之间无显著差别（ P ＞0．05）。【结论】RIPerC与RIPreC均能显著降低瓣膜置换手术中的IL‐6的释放和L A的生成，减轻炎性反应及缺血再灌注的损伤，而两者之间比较无明显差别。
【목적】관찰원격결혈동처리（RIPerC）여원격결혈예처리（RIPreC）재판막치환수술중대유산（LA）화백개소6（IL‐6）급양합지수（PaO2／FiO2）적영향。【방법】선취판막치환술적환자120명，장기수궤분위삼조：대조조（A조），하지결혈동처리조（B조）화하지결혈예처리조（C조），매조40명。B조우체외순배주동맥조단후실행3개주기결혈／재관（5／5 min）적우하지결혈시처리，C조우기관삽관마취후진행3개주기5／5 min적우하지결혈예처리。관측술후삼조환자적호흡궤철리시간，ICU정류시간，IL‐6，PaO2／FiO2，LA적변화。【결과】화대조조비교，B조화C조호흡궤철리시간화ICU정류시간명현축단，PaO2／FiO2교대조조고，IL‐6화LA교대조조저，단량개처리조지간무현저차별（ P ＞0．05）。【결론】RIPerC여RIPreC균능현저강저판막치환수술중적IL‐6적석방화L A적생성，감경염성반응급결혈재관주적손상，이량자지간비교무명현차별。
[Objective]To observe the impact of remote ischemic preconditioning (RIPerC) and remote is‐chemic preconditioning(RIPreC) on lactate(LA) ,interleulin‐6(IL‐6) and oxygenation index(PaO2/FiO2 ) dur‐ing valve replacement .[Methods]Totally 120 patients undergoing valve replacement were chosen and randomly divided into control group(group A ,n=40) ,lower limb ischemic perconditioning group(group B ,n=40) and lower limb ischemic preconditioning group(group C ,n=40) .Group B received 3 cycles of 5/5min right lower limb ischemic perconditioning after aortic was clamped .Group C received 3 cycles of 5/5min right lower limb ischemic preconditioning after tracheal intubation anesthesia .After surgery ,the weaning time of ventilator , ICU stay ,IL‐6 ,PaO2/FiO2 and LA in 3 groups were observed .[Results]Compared with control group ,the weaning time of ventilator and ICU stay in group B and group C were obviously shortened ,and PaO2/FiO2 was increased ,and LA and IL‐6 were decreased .There was no significant difference between two treatment groups ( P >0 .05) .[Conclusion] Both RIPerC and RIPreC can markedly reduce the release of IL‐6 and LA during valve replacement ,and alleviate inflammatory response and ischemic reperfusion injury ,but there is no obvious difference between them .